According to the nonpartisan Congressional Budget Office (CBO), premiums for a 64-year-old earning $26,500 a year would increase by a whopping $14,400 in 2026. In addition, people with preexisting conditions may not even be able to purchase health insurance because the prices would be prohibitively high.

Three weeks ago, the House voted 217 to 213 to repeal and replace the Affordable Care Act (ACA) without waiting for the CBO to analyze the effects of the legislation. Today the CBO and the staff of the Joint Committee on Taxation (JCT) provided their assessment, which is required before the bill can be sent to the Senate for consideration.

Among other things, the CBO estimated a reduction in the deficit of $119 billion under the bill over a 10-year period. The bill would lower health-related spending by the federal government through steep reductions in Medicaid and the replacement of current subsidies with less-generous tax credits. At the same time, the bill would grant large tax cuts to drugmakers and insurance companies.

The congressional analysts warn that for a significant segment of the population, the individual insurance market “would start to become unstable in 2020” because of two provisions added to the House bill in the days before the May 4 vote. One would allow states to receive waivers allowing insurers to eliminate coverage for essential health benefits, such as emergency services, hospitalization and chronic disease management. The other is a waiver that would allow insurers, contrary to current law, to charge higher premiums to people with preexisting conditions such as cancer and diabetes.

According to the report, “less healthy people would face extremely high premiums” in states likely to receive these waivers. “People who are less healthy (including those with preexisting or newly acquired medical conditions) would ultimately be unable to purchase comprehensive nongroup health insurance at premiums comparable to those under current law, if they could purchase it at all.”

AARP reiterated its strong opposition to the bill and called on the Senate to shelve the House-passed legislation. AARP said the bill would impose an “age tax” on older Americans by allowing insurers to charge premiums five times what they charge others and cutting the current level of subsidies.

“The CBO analysis found that premiums would go up to unaffordable levels by inflicting an age tax and removing current protections for people with common conditions including diabetes and weight gain,” said Nancy LeaMond, AARP Executive Vice President. “Putting a greater financial burden on older Americans is not the way to solve the problems in our health care system.”

AARP said it rejected the bill because it worsens the financial outlook for Medicare by reducing Medicare’s revenue and slashes Medicaid spending by over $800 billion over 10 years.

New budget proposal also would slash health research funding

En español | The Trump administration today released a federal budget proposal that would cut more than a trillion dollars over 10 years from Medicaid, the nation’s largest source of health care coverage, which provides a lifeline for children and adults with disabilities and low-income seniors. Under the president’s proposal, Medicaid would face a $600 billion decrease. That’s in addition to the more than $800 billion cut in the American Health Care Act (AHCA) passed this month by the House of Representatives.

The budget, released while President Trump was in the Middle East on his first foreign trip as president, also would shrink funding for the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), the Children’s Health Insurance Program (CHIP), Social Security disability, environmental protection, and housing and transportation assistance.

At the urging of the president’s daughter Ivanka Trump, the budget proposes spending $25 billion over the next 10 years on paid parental leave, a new initiative.

Members of both parties in the House and the Senate have strongly opposed trimming Medicaid in the past.

Many of the other cuts also face strong bipartisan opposition on Capitol Hill. For example, Rep. Tom Cole (R-Okla.), chairman of the House Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies, has sharply criticized the cuts earmarked for the NIH and CDC.

White House Budget Director Mick Mulvaney reiterated the administration’s view that the AHCA does not go far enough on Medicaid. “We go another half a step further and ratchet down some of the growth rates that are assumed into AHCA,” he said in a call with reporters on Monday.

During today’s press briefing, Mulvaney said that “we’re no longer going to measure compassion by the number of programs or the number of people on those programs, but by the number of people we help get off of those programs.”

AARP staked out a strong position against the president’s budget.

AARP “opposes the budget proposed today because it explicitly harms the very people we are counting on the President to protect,” said AARP Executive Vice President Nancy LeaMond in a statement. “Today’s budget proposes to cut Social Security benefits, as well as funding for critical health, hunger, housing and transportation assistance to low and middle income seniors. The budget sends a powerful message to older Americans and their families that their health and financial security is at risk.”

AARP sounded a positive note on the administration’s parental leave initiative. “We do want to acknowledge the Administration’s paid leave proposal,” LeaMond said. “Although it must be improved so that it addresses the workplace needs of family caregivers, we hope that it leads to a national conversation about ways to support family caregivers in the workplace.”

The budget assumes economic growth reaching 3 percent a year by 2021, a figure widely seen as unrealistic.

The budget also includes a dramatic decrease in the Supplemental Nutrition Assistance Program (SNAP), also known as food stamps. “If you are on food stamps, we need you to go to work,” said Mulvaney. “If you are on disability and should not be, we need you to go back to work.”

The president’s budget is the first step in a lengthy process. Congress will set its own priorities as it develops its own budget resolution.